struggling to latch, is expressing the solution?

[nightowlmostly]

My first baby was born two days ago, and we are having trouble with feeding. He only had a syringe of colostrum in the hospital in the first 24 hours, at which point we gave him some formula to make sure he'd eaten something.

We are home now and he's had a few bottles to keep him going but I really want to get breastfeeding working for us. The problem is that he just won't suck when on the breast. He sucks fingers and teats fine, so that's not the issue, and no tongue tie either. He will put my nipple in his mouth and even make the sucking motion, but only for a minute then he'll just go to sleep on me!

I'm thinking about getting a breast pump to express while we try to sort it out but am not sure whether an electric or manual will be best, or what. Please if you have any advice, I'm getting a bit stressed.

Thanks all!

I think you need some reall life help. Can you have the midwife come out you should be able to call them anytime at this point in time and they should come out and help with feeding.

The problem is giving a bottle can confusse things at this stage it better to syring feed or cup feed your baby is only two days old and only needs a really small amount of colostrum at this age (average feed is probably around 5-10ml at this age). Yes you need to exprecess to help your milk come in but baby's are the one's that are best at doing this not a pump and help with latching and feeding your baby is what you really need at this stage.

You say he's latching on then falling asleep is he still sucking while alseep? This can be normal behavour for tiny baby's but his feeding really does need to be assesed by some one who knows what to look for.

kellymom.com/bf/normal/newborn-nursing/

If u say he sucks a bit on the breast and then falls asleep there's a couple of things u could try. Before a feed ur baby needs to b nice an alert. So strip then to their nappy (you get some skin to skin then too) when they are latched massage the palm of their hand with your thumb. It stimulates the suck reflex. Then just do stuff to keep them awake. Like blowing their hair, stroking/tickling their cheek/ear

Thanks, I've tried loads of things like skin to skin and keeping him up, even the palm thing! I had my midwife come round earlier, she reckons try to get him to feed from the breast when he's due a bottle feed, and persevere for a good while. The thing is, he gets distressed after a while of trying to force the issue and I'm worried it'll put him off. Yesterday he would be lying on me quite happy till I offered him the breast then he'd start crying straight away! I hate that it's such a struggle because I do want it to work, but I guess if it comes to expressing and giving it to him via a bottle then that's not a bad compromise. The midwife says he's a lazy boy!

It all sounds quite normal to me. The problem with introducing bottles this early is precisely that: they may prefer it to the breast as less work. Just keep doing lots of skin to skin. Good luck

to call a 2 day old baby lazy!

I agree with you nightowl that you don't want to force him - babies particularly don't like the back of their head being held and it can 'turn off' their feeding instinct.

I'd suggest the following -

• have a warm bath with your baby- lots of cuddling, but no forcing. Some suggest that this can kind of hit the 'rebirth' switch.

*try breast compressions when you do manage to get him on the breast. (see Dr Jack Newman site for clips )

*Have a look at biological nurturing- allow your baby to lie on top of you, skin to skin, and see if he will come to the breast by himself. (google for more info)

• hand express and offer the colostrum on a spoon or syringe like you did in hospital. As Migril said, he will need teeny quantities at this stage and the formula could be filling him up if you are giving him too much.

Hope some of that may be of some help. Incidentally- what sort of birth did you have? Sometimes this can affect breastfeeding. How much help with latching did you get from the mws ?

Hi again, crikeybadger thanks for the tips. The midwives were quite supportive in hospital I guess, every 2 hours they sent someone new to try and get him to latch but it didn't work. By the end I'd been awake for 40 hours with a couple of short naps and he wasn't feeding at all still, and getting very distressed. At the time I felt the best thing was to give him a bottle and get us all home as I couldn't take it any more.

It's horrible, I feel so shit about it. I've managed to express one feed each day to go alongside the formula, so at least he's had some breastmilk. I was so sure that I would breastfeed, I'm really upset by the idea it may not work out. I wanted to go to a baby brasserie the other day but couldn't leave the house due to being in a lot of pain from my episiotomy. The next one is on monday, I'm going to that one.

I really feel that I've made the best decisions that I could have at each point in time looking back, but I still feel really crap about it. What if it's too late now to bf? He might have got used to a bottle and never feed from me. I want to try and bf but feel that I should wait till I get proper advice, I don't want to mess it up any more! My hormones aren't helping either, I'm crying a lot about it too. It's weird, it's so emotive. Rationally I think if I can express a decent amount and mix feed then that's ok, but emotionally I feel like I've let him down.

Thanks if you read all that, it's good to get it out!

nightowl dont worry- get the midwives out or ring le leche league they ahve counsellors that can come out to your house. You may ahve a feeding coordinator who may be attached to your area who can come and help- you can get access to them by the midwife. Get someone to come and sit with you and watch trying to latch LO on.

Dont put yourself under so much pressure. Good idea to express if you can and do breast massage too btu keen on persevering with latching him on. some babies can be lazy not saying that is the case with him. If you are worried re him getting used to the bottle then syringe milk.

But I seriously think you need to get someone out to help you I agree with all the above.

Keep positive, BF is very emotive but dont let it get on top of you. let us know how things are

it's not too late, don't worry.

he's still so new to this!
i remember being worried in the first week that dd only seemed to want to feed every 5 hours - i didn't know what i was doing so would wait for her to "look" hungry.

and she did just what your ds is doing.
you just have to keep trying to keep him awake - like the others have said, with the stroking - dd used to do sucksucksuck then seem to sleep. (they didn't have this hassle in the womb!)So I felt like i spent the whole feed stroking her head or hand (i found the most effective was the dipped bit just behind her ear), but when i forgot, and just sat there, eventually she would suck again on her own.
and squeeze your boob when he's latched. not as if you're expressing, but just a little squeeze. he'll get the idea.

are you still in bed?
all you need is food, drink and the remote control.

keep trying and keep persevering. if you think the latch is fine, then it's all fine. :)

Hi, an update!

I went to the midwife two days ago, and she showed me how to hold him under my arm which feels better. He has latched on twice since, but only for a few seconds each time. I just don't know how to persuade him to actually feed from me when he knows if he just waits a bottle will be forthcoming!

She said because it was a slightly difficult birth that might be why he didn't feed straight away, and that might have contributed to the issues we're having. He hasn't fed from me at all. I'm expressing, but my supply is dwindling because I'm finding it hard to fit it in around actually feeding him, changing and getting some sleep! He doesn't always sleep in his basket, like now, he wants to be held. That's obviously what I have to prioritise, but it means I haven't had a chance yet today to express. I was going to go to a baby brasserie on Monday, but am starting to feel like I'm flogging a dead horse and it'll just make me cry!

It's getting me down tbh. On top of that I think part of my episiotomy is coming apart. I find myself crying a lot, is that just normal hormonal things at day 8? I have a history of getting a bit down sometimes, so am keeping an eye out for PND. I get upset when I think about the birth as well, that's another story but it didn't go to plan and was quite stressful, although there was no harm done in the end. I can't imagine talking about it with my NCT group without getting into a state. Maybe it'll be easier in a few days/weeks.

Sorry, went a bit off track there. I guess all these things are intertwined in my mind. Thanks for reading, any reassurance you can give would be great!

how long do you wait until you offer the bottle?

I've also found with DD, that if she's crying when I feed her, she's more likely to struggle to latch. If she's keen to eat, but not yet begging for it, she latches a lot more readily. I don't know if that will help you at all.
My normal piece of advice is to just spend all day in bed (for a couple of days if you need to) and just keep eating and drinking and offering the breast.

If he sees that there's food on tap, without having to wait for it, he should come round (eventually)
It just seems like such a loooooong time in the early days.

sorry, didn't comment on the next bit.
My episiotomy stitches felt like they were coming apart too - the uncomfortableness in the underbeneathsies for aaages was horrible! One of my stitches did come out - I've got a little blob at the end of the scar now. (at first it came a bit loose and then I think it loosened all the way by the time the thread dissolved)

Don't worry about crying right now - you will feel teary to start with.
I don't want to tell you to ignore it, because I don't know anything about PND, so I don't want to put my foot in it.

But do take care of yourself. Get your DP (if you have one) to run around after you, and have a lovely warm bath for a while.
keep drinking!

btw, the more you hold him (if you're naked, that will be better for this) the more likely you are to be able to get him to latch and feed.
Sort of keep his nose/lips near your nipples when you hold him. He should find the smell of the milk very attractive.
:)

DS was like this in the first few weeks: would get so worked up crying during BFing that he couldn't get latched on for long. So I expressed milk and gave that to him, to give both of us a rest from the frustations and make sure he was at least being fed. I continued to try BF in between, and after a few weeks he suddenly 'got it' and off he went.

I did use a bottle for expressed feeds and it doesn't seem to have stopped him learning to BF, but I appreciate that it's not recommended to do so.

My advice is to give expressing a go so at least you know he gets fed, your supply stays up and it will give you and him time to learn the trick in your own time.

Thanks, I'm feeling a bit more positive now. I'm up and down, I guess that's to be expected! Good news about the stitches, maybe they'll be ok. They did get checked on Thursday and the GP said they were ok.

I just get really upset when I try to get him to latch on, I'm finding it stressful. Then I feel like I'm making excuses for giving him a bottle instead and the guilt kicks in! I just don't know what to do. Am torn between making the choice to ff but with as much bm as I can express as well, or going to the baby brasserie and keeping trying.

This parenting malarkey is hard going! I suppose it's true what they say about feeling guilty about stuff forever!

he can tell that you're frustrated, too. :(

I found it amazing to learn that - if you get stressed, he can feel it, and it makes him stress too.

I found with DD, that if I calmed myself down, but out loud, then she calmed down too. "there there mummy's okay, mummy's okay" while gently stroking the head. :)

It all sounds very hard for you nightowl- the difficult birth, the tricky feeding plus all the sterilising and expressing on top of that. No wonder you are teary.

But you're right that your supply will dwindle if you can't stimulate it either by expressing or direct feeding. Really you would need to be expressing alot- 8-10 times a day and at least once in the night. It's a lot of work for sure.

You may find that you can work out what to do by talking things over with somebody from one of the breastfeeding helplines. Certainly, once you are feeling stronger then having a birth 'debrief' with somebody from the hospital may be of use to you.

Your mw could be right that a difficult birth has made breastfeeding painful for him - cranial osteopathy has helped some babies in a similar situation.

Hope you have a good day today.

Hi all, thanks for your advice. I think I have decided that for me the right thing is to focus on expressing from now on. I tried again yesterday to feed him directly, but he just won't have it and it makes me really upset. I feel so guilty about not being able to achieve what I feel should be quite a natural process, and keep thinking about what if I'd done x y or z differently. I just have to accept the situation for what it is and move on in a positive frame of mind. Keeping on trying is depressing in the extreme.

Sorry if I sound like I'm trying to justify my decision, but I suppose I am! I know a lot of people are happy with formula feeding and make a positive choice to do it, but I was so determined i would breastfeed, tbh it's come as a bit of a shock to me that it's been a problem. I just keep telling myself that a little bm is better than none, and he's getting one or two of his feeds from me every day at the moment.

I'm going to start a new thread specifically asking for advice on the best way to express, and increase my supply, as it's dwindling and the last thing I want is for it to dry up altogether.

Thanks to everyone for their help!

Hi, I couldn't read this without posting (apologies that this will be quite long!).
I've been in exactly the same situation twice now. Both of my children were early and had jaundice and neither really latched on in the hospital or even when we got home despite lots of midwife help. Personlly, I found that the skin on skin advice just meant they slept and made no attempt at latching!

With my son I also got give really bad advice from health visitors that because my son had thrush in his mouth that I shouldn't attempt to breast feed until it cleared up so we didn't really start attempting to feed really until he was around 8 weeks, by which time it was just too late. I did go down the expressing route and he had breast milk exclusively until around 10 months when I went back to work and it got too much so it can be done for a long time but it is time consuming and might not work for everyone. I was lucky that my son was a good sleeper so I could feed, put him down to sleep and then express. I found that to start with I needed to express regularly to get my supply started (ie do both boobs every six hours) and the bad news is that expressing in the middle of the night (like you'd do for a feed) really does help up your supply but you have to be resigned to not having as much sleep as you could have. Also, call your local NCT and see if you can hire a double electric breast pump or if there is one available from the hospital. If you go down this route, there is no point doing one boob and then another as I found doing both helped my supply and saved time, especially when you want to get back to sleep. Also massaging the breasts while expressing (you do develop an art to it!) helped up my supply.

On a more positive note, with my daughter I ended up expressing to get my supply started but this time I went straight to a baby cafe as soon as I got out of hospital and got much better advice. It's definately better getting paractical advice, but I found that continuing to persevre did mean that we have got there in the end although it wasn't until she was 6 weeks old so don't worry if it's not working straight away. If you can keep your supply up there is still plently of time to sort it out. I found that to start with, I just put her to the breast for a few minutes when she needed a feed, then when she'd get frustrated, we'd give her a bottle of expressed milk (or formula if I hadn't managed to express enough). I found that it took her about 2 weeks before she'd even latch for a little while and lots of help from baby cafes with different positions (and lots of tears along the way) we've finally got there but I think the best advice I can give is that although some people and babies just 'get it' straight away, for some of us there is a learning curve and second time I think I've found that if you can not get so stressed but if you're determined and look at it that it is a new skill and both you and the baby have to learn. Even if you can only have one bottle of expressed milk a day (express while there's someone else to look after the baby so you don't get so worried!) at this point in time, just that effort can mean that you still might get them to the boob in a few weeks time.

I wish you all the best for however things go.

That sounds like a good plan nightowl.

Can you manage to get him latched on at all at the moment? If you are, you may find that a supplemental nursing system would help. Medela do them see here. They are pricy though.

I think you're right that it comes as a shock when breastfeeding isn't as easy as we all think it is. The concept is simple, but the reality is far from that for some people.

But as you've said, every breastfeed counts, so don't give up hope.

feel so guilty about not being able to achieve what I feel should be quite a natural process, and keep thinking about what if I'd done x y or z differently.

I know how you feel! After reading everywhere that BFing is 'natural', it came as a shock to me that it's actually a learned skill, and that both me and baby had to work hard to learn how to do it. Don't feel guilty, when it comes to struggling with BFing you're definitely not alone. Time and perseverance will hopefully sort out most of your problems, but if they don't, formula is a very nutritious drink for your child as well. Do what feels right.

Sorry, haven't read all the replies so this may have already been said but, firstly, are you absolutely 100% sure he doesn't have a tongue tie? Secondly, what sort of nipples do you have - sticky out ones or flatter (it's ok, we're all friends )?

I had a long line of doctors and midwives reassure me for weeks that DS (my first) didn't have a tongue tie, or later "only a very slight one" as he could get the tip of his tongue over his gum line. He did have a tongue tie, still does in fact (now 3 years old and it's affecting his speech). It was just one of the ones that is attached further back so less visible. That combined with my flat-ish nipples dealt the kiss of death to my bfing days with DS .

FWIW I think you are doing entirely the right thing to concentrate on the pumping. I dilly dallied for 3 weeks before committing to a proper pumping schedule and by then it was too late to save my supply (plus I ended up with a very nasty abscess that could have been avoided).

I just knew (like I suspect you do) that something was very wrong and got deeply frustrated with being repeatedly told by the midwives and HVs to simply rest or have more skin to skin and, in essence, to try harder. It makes me very sad because, looking back, I believe that with the right kind of support I could have succeeded.

Hi, just wanted to pop back and update for those kind enough to give me advice on this thread.

Unfortunately, pumping really didn't work out, my supply just got less and less every day, despite expressing more and more often. I was told to express 8 to 10 times a day, which was quite unachievable what with trying to feed and change him, hold him most of the time and get some sleep too! I was doing it 4 or 5 times a day, so every 3 or so hours but every day the amount I could get got less and less, the last day I could only get about 15 mls from both breasts.

I think my milk has just gone, when I stopped I didn't get any discomfort or swollen breasts like they were when my milk first came in, they have just gone back to feeling normal over the course of a few days.

So, I feel my bfing was doomed from the start! I am disappointed, but have stopped torturing myself over it as it was starting to become an issue and I was getting quite down about it. I have accepted that it just isn't to be, and am feeling a lot better.

Thanks all for your advice, hopefully I'll get on better next time. The midwife said maybe they'll give me something to increase my supply next time around.